Diagnosing Hoof Lameness due to Multiple Causes (AAEP 2012)

“Largely because of MRI, we have a greater understanding of the close anatomic and functional relationship of various bony and soft tissue structures in the equine foot,” said Spriet.

Photo: Rood & Riddle Equine Hospital

Traditional means of diagnosing and effectively treating foot pain have been wrought with challenges and disappointment, particularly when the focus is on deep digital flexor tendon (DDFT) injury. One University of California, Davis, veterinarian and his colleagues recently determined they could diagnose and treat foot pain more successfully if they considered that multiple abnormalities could actually be contributing to the lameness, rather than just a single problem.

“Largely because of MRI, we have a greater understanding of the close anatomic and functional relationship of various bony and soft tissue structures in the equine foot,” said Mathieu Spriet, DVM, MS, Dipl. ACVR, Dipl. ECVDI, of the UC Davis School of Veterinary Medicine in his presentation at the 2012 American Association of Equine Practitioners Convention, held Dec. 1-5 in Anaheim, Calif.

In addition to damaging the DDFT, which runs along the back of the cannon bone and pastern to its insertion on the distal phalanx (coffin bone), the horse can injure other soft tissues, including the distal sesamoidean impar ligament, which extends between the navicular and coffin bones. Further, a horse can even develop bony changes, such as resorption (breakdown) or the formation of cystlike lesions.

To show that these lesions can (and do) occur in concert, Spriet and colleagues reviewed and compared the MRIs and radiographs of 82 horses with lameness localized to the lower aspect of the front limbs. They assessed both the bones and soft tissues for abnormalities and found:

Eight of the 82 cases had evidence of bony resorption on MRI;

They commonly noticed concurrent injury to the DDFT and navicular bone in those eight horses; and

Using traditional radiography they could also detect bony changes in the foot (sensitivity was 0.55, specificity was 0.96, meaning that they correctly diagnosed bony resorption in approximately 50% of the cases with a lesion visible on MRI).

“This study shows that both MRI and radiographs can identify bony resorption of the coffin bone, and that when this change is noted, there are likely to be other disease conditions or injuries to nearby structures such as the DDFT or navicular bone,” summarized Spriet.

About the Author

Stacey Oke, MSc, DVM, is a practicing veterinarian and freelance medical writer and editor. She is interested in both large and small animals, as well as complementary and alternative medicine. Since 2005, she's worked as a research consultant for nutritional supplement companies, assisted physicians and veterinarians in publishing research articles and textbooks, and written for a number of educational magazines and websites.

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